Effect of temporal corneal phacoemulsification on intraocular pressure in eyes with prior trabeculectomy with an antimetabolite

Kala Swamynathan, Angelita P. Capistrano, Louis Cantor, Darrell WuDunn

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Objective To evaluate the effect of temporal corneal phacoemulsification on intraocular pressure (IOP) in eyes after primary trabeculectomy with intraoperative fluorouracil (5-FU) or mitomycin C (MMC). Design Retrospective case-control study. Patients Twenty-nine patients who were participants in a prospective randomized double-masked trial comparing the efficacies of intraoperative 5-FU and MMC and who underwent temporal corneal phacoemulsification after the primary trabeculectomy were matched to 29 patients enrolled in the same study who did not undergo cataract surgery. The 2 groups were matched for length of follow-up after the trabeculectomy and the antimetabolite used at the time of trabeculectomy. Methods Comparisons of IOP, visual acuity (VA), and the number of glaucoma medications were made between the 2 groups and within the groups at various follow-up intervals to detect any statistically significant differences. Main outcome measures Intraocular pressure before phacoemulsification and at various times postoperatively were compared with IOP in the control group at the matched follow-up times. Results The mean of all IOP measurements beyond 3 months after phacoemulsification for each subject was significantly higher than the prephacoemulsification IOP (11.8±4.2 vs. 8.7±4.5 mmHg; P = 0.00003, paired t test). In contrast, the mean IOP remained stable in the control group during the equivalent time period (9.6±3.5 vs. 9.1±3.1 mmHg; P = 0.42, paired t test). Postphacoemulsification IOP was significantly higher than the corresponding IOP in the time-matched control group (P<0.003, analysis of covariance). Mean VA improved significantly after the phacoemulsification (P = 0.0002) but remained stable in the control group. Conclusion Temporal corneal phacoemulsification can affect long-term IOP control after trabeculectomy with 5-FU or MMC.

Original languageEnglish
Pages (from-to)674-678
Number of pages5
JournalOphthalmology
Volume111
Issue number4
DOIs
StatePublished - Apr 2004

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Antimetabolites
Trabeculectomy
Phacoemulsification
Intraocular Pressure
Fluorouracil
Mitomycin
Control Groups
Visual Acuity
Research Design
Glaucoma
Cataract
Case-Control Studies
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Effect of temporal corneal phacoemulsification on intraocular pressure in eyes with prior trabeculectomy with an antimetabolite. / Swamynathan, Kala; Capistrano, Angelita P.; Cantor, Louis; WuDunn, Darrell.

In: Ophthalmology, Vol. 111, No. 4, 04.2004, p. 674-678.

Research output: Contribution to journalArticle

Swamynathan, Kala ; Capistrano, Angelita P. ; Cantor, Louis ; WuDunn, Darrell. / Effect of temporal corneal phacoemulsification on intraocular pressure in eyes with prior trabeculectomy with an antimetabolite. In: Ophthalmology. 2004 ; Vol. 111, No. 4. pp. 674-678.
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abstract = "Objective To evaluate the effect of temporal corneal phacoemulsification on intraocular pressure (IOP) in eyes after primary trabeculectomy with intraoperative fluorouracil (5-FU) or mitomycin C (MMC). Design Retrospective case-control study. Patients Twenty-nine patients who were participants in a prospective randomized double-masked trial comparing the efficacies of intraoperative 5-FU and MMC and who underwent temporal corneal phacoemulsification after the primary trabeculectomy were matched to 29 patients enrolled in the same study who did not undergo cataract surgery. The 2 groups were matched for length of follow-up after the trabeculectomy and the antimetabolite used at the time of trabeculectomy. Methods Comparisons of IOP, visual acuity (VA), and the number of glaucoma medications were made between the 2 groups and within the groups at various follow-up intervals to detect any statistically significant differences. Main outcome measures Intraocular pressure before phacoemulsification and at various times postoperatively were compared with IOP in the control group at the matched follow-up times. Results The mean of all IOP measurements beyond 3 months after phacoemulsification for each subject was significantly higher than the prephacoemulsification IOP (11.8±4.2 vs. 8.7±4.5 mmHg; P = 0.00003, paired t test). In contrast, the mean IOP remained stable in the control group during the equivalent time period (9.6±3.5 vs. 9.1±3.1 mmHg; P = 0.42, paired t test). Postphacoemulsification IOP was significantly higher than the corresponding IOP in the time-matched control group (P<0.003, analysis of covariance). Mean VA improved significantly after the phacoemulsification (P = 0.0002) but remained stable in the control group. Conclusion Temporal corneal phacoemulsification can affect long-term IOP control after trabeculectomy with 5-FU or MMC.",
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N2 - Objective To evaluate the effect of temporal corneal phacoemulsification on intraocular pressure (IOP) in eyes after primary trabeculectomy with intraoperative fluorouracil (5-FU) or mitomycin C (MMC). Design Retrospective case-control study. Patients Twenty-nine patients who were participants in a prospective randomized double-masked trial comparing the efficacies of intraoperative 5-FU and MMC and who underwent temporal corneal phacoemulsification after the primary trabeculectomy were matched to 29 patients enrolled in the same study who did not undergo cataract surgery. The 2 groups were matched for length of follow-up after the trabeculectomy and the antimetabolite used at the time of trabeculectomy. Methods Comparisons of IOP, visual acuity (VA), and the number of glaucoma medications were made between the 2 groups and within the groups at various follow-up intervals to detect any statistically significant differences. Main outcome measures Intraocular pressure before phacoemulsification and at various times postoperatively were compared with IOP in the control group at the matched follow-up times. Results The mean of all IOP measurements beyond 3 months after phacoemulsification for each subject was significantly higher than the prephacoemulsification IOP (11.8±4.2 vs. 8.7±4.5 mmHg; P = 0.00003, paired t test). In contrast, the mean IOP remained stable in the control group during the equivalent time period (9.6±3.5 vs. 9.1±3.1 mmHg; P = 0.42, paired t test). Postphacoemulsification IOP was significantly higher than the corresponding IOP in the time-matched control group (P<0.003, analysis of covariance). Mean VA improved significantly after the phacoemulsification (P = 0.0002) but remained stable in the control group. Conclusion Temporal corneal phacoemulsification can affect long-term IOP control after trabeculectomy with 5-FU or MMC.

AB - Objective To evaluate the effect of temporal corneal phacoemulsification on intraocular pressure (IOP) in eyes after primary trabeculectomy with intraoperative fluorouracil (5-FU) or mitomycin C (MMC). Design Retrospective case-control study. Patients Twenty-nine patients who were participants in a prospective randomized double-masked trial comparing the efficacies of intraoperative 5-FU and MMC and who underwent temporal corneal phacoemulsification after the primary trabeculectomy were matched to 29 patients enrolled in the same study who did not undergo cataract surgery. The 2 groups were matched for length of follow-up after the trabeculectomy and the antimetabolite used at the time of trabeculectomy. Methods Comparisons of IOP, visual acuity (VA), and the number of glaucoma medications were made between the 2 groups and within the groups at various follow-up intervals to detect any statistically significant differences. Main outcome measures Intraocular pressure before phacoemulsification and at various times postoperatively were compared with IOP in the control group at the matched follow-up times. Results The mean of all IOP measurements beyond 3 months after phacoemulsification for each subject was significantly higher than the prephacoemulsification IOP (11.8±4.2 vs. 8.7±4.5 mmHg; P = 0.00003, paired t test). In contrast, the mean IOP remained stable in the control group during the equivalent time period (9.6±3.5 vs. 9.1±3.1 mmHg; P = 0.42, paired t test). Postphacoemulsification IOP was significantly higher than the corresponding IOP in the time-matched control group (P<0.003, analysis of covariance). Mean VA improved significantly after the phacoemulsification (P = 0.0002) but remained stable in the control group. Conclusion Temporal corneal phacoemulsification can affect long-term IOP control after trabeculectomy with 5-FU or MMC.

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